CHRISTINE L WILDEMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

CHRISTINE

Middle

Last Name

WILDEMAN

Suffix

Business Name

CHRISTINE L WILDEMAN MD

Original Issue Date

06/22/2004

Effective Date

06/22/2004

Expiration Date

07/31/2008

City

CARTHAGE

State

Zip

62321

County

HANCOCK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/06/2008